SyphilisSigns And Symptoms

Syphilis usually has an incubation period of approximately 10 up to 90 days, with an average of 3 weeks. This is when primary Syphilis appears.

Syphilis symptoms occur in stages: primary syphilis, secondary syphilis, latent syphilis, and tertiary syphilis.

Primary syphilis is usually marked by the appearance of painless sores (called chancres) on the penis or scrotum of 70% of men with syphilis and on the vulva, cervix, or perineum of more than 50% of women with syphilis. The chancre usually heals within 4-8 weeks, with or without treatment. The primary lesion has a surrounding red areola. The edge and base of the ulcer have a buttonlike consistency on touching. When abraded, this chancre releases a clear serum containing numerous T pallidum organisms. Extragenital lesions can also occur above the neck, typically affecting the lips or oral cavity. The regional lymph nodes usually enlarge painlessly and are firm, discrete, and nontender. Nevertheless, there are other diseases that can be mistaken for primary syphilitic lesions. These include herpes simplex (primary and recurrent infection), chancroid, traumatic superinfected lesions, carcinoma (a malignant tumor that begins in the lining layer of organs; at least 80% of all cancers are carcinomas), mycotic infection, granuloma inguinale, lichen planus (a common skin disease in which itchy, small, pink or purple spots appear on the arms or legs), psoriasis (a chronic disease of the skin marked by red patches covered with white scales), fungal infection, venereal chlamydial infections.

Secondary syphilis is characterized by the appearance of a cutaneous eruption (skin rash) within 2-10 weeks after the primary chancre and is most florid 3-4 months after infection. The eruption may be subtle (25% of patients may be unaware of skin changes). It can spread over the entire body or it may be limited to certain areas. These lesions are red and have 3-10 mm in diameter. The eruption can be contagious, so it is important to avoid skin-to-skin contact with an uninfected person. The lesions often become necrotic and are distributed widely with frequent involvement of the palms and soles. Other symptoms of secondary syphilis include mild symptoms of malaise, headache, anorexia, nausea, aching pains in the bones, and fatigue often are present, as well as fever and neck stiffness. A small number of patients develop acute syphilitic meningitis and experience headache, neck stiffness, facial numbness or weakness, and deafness. Secondary syphilis symptoms can also disappear without treatment and they can reoccur for up to 2 years before progressing to the next stage of the disease. Drug eruptions, pityriasis rosea (a common skin condition characterized by scaly, pink, and inflamed skin), psoriasis, lichen planus, viral exanthema (a widespread rash) may be mistaken for secondary syphilis due to the high resemblance of the eruption.

Some of the people infected with syphilis may experience a latent (hidden) stage, during which all symptoms disappear. This stage can last many years, but it is still contagious. In the late stages of syphilis, it may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This internal damage may show up many years later. Symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.